Provider Demographics
NPI:1750839148
Name:SANABRIA LOPEZ, JOHNNY ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:JOHNNY
Middle Name:ALEXANDER
Last Name:SANABRIA LOPEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 365067
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-5067
Mailing Address - Country:US
Mailing Address - Phone:787-754-0101
Mailing Address - Fax:787-751-3911
Practice Address - Street 1:PUERTO RICO MEDICAL CENTER
Practice Address - Street 2:NEUROLOGY DEPARTMENT, 5TH FLOOR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-5067
Practice Address - Country:US
Practice Address - Phone:787-754-0101
Practice Address - Fax:787-751-3911
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS310332084N0400X
FL1536612084N0400X
PR194132084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology